Bipolar Disorder Across the Lifespan

Bipolar disorder can affect people of all ages. It may begin as early as infancy. When the disorder begins in childhood or early adolescence, it may be a different, possibly more severe form of the illness than when the illness begins in late adolescence or adulthood. Symptoms of mania and depression in children and teens may also be different from symptoms in adults.

Children and Adolescents

Mania in children often appears as extreme irritability or rage. Children and teens are more likely to have destructive outbursts than to be excited or euphoric. Depression in early life may have symptoms such as headaches, muscle aches, stomachaches or tiredness, frequent absences from school or poor performance in school, talk of or efforts to run away from home, irritability, complaining, unexplained crying, isolation, poor communication and extreme sensitivity to rejection or failure. Other signs of a possible mood disorder are alcohol or substance abuse and difficulty making or keeping friends.

Young people may also have a continuous, rapid-cycling, irritable and mixed symptom state that may co-occur with disruptive behavior disorders, particularly attention deficit hyperactivity disorder (ADHD) or conduct disorder (CD). Young people may have features of ADHD and CD before having bipolar symptoms.

A child or adolescent who has symptoms of depression along with ADHD-like symptoms that are very severe, with excessive temper outbursts and mood changes, should be evaluated by a psychiatrist or psychologist with experience in bipolar disorder, particularly if there is a family history of the illness. This evaluation is especially important since medications prescribed for ADHD may worsen manic symptoms.

Bipolar disorder that begins in late teen or adult years tends to begin suddenly, often with a classic manic episode. In adults, the illness has more defined ups and downs with relatively stable periods between episodes. There is also less co-occurring ADHD or CD among adults with bipolar disorder.

As people get older, symptoms of bipolar disorder may change in nature and severity. Because of this, treatments and medications may need to be adjusted. It helps to become an expert on your own symptoms and triggers and to build a support network throughout your life.


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Older Adults

It is uncommon for bipolar disorder to appear for the first time in late life but some people may have symptoms throughout adulthood and not be diagnosed until later in life. For older adults, it is important to have a complete medical examination, and to discuss all mental health history, family history and current medications with health care providers. Other illnesses and the medications that treat them may trigger or mimic bipolar symptoms. Older adults may tolerate or metabolize medications at different speeds that younger adults, so they may need different dosages. Talk therapy, group therapy and peer support, including DBSA support groups, can be valuable additions to older adults' treatment.


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